Abstract

Introduction: Hypertension seems to be a major problem in dialysis patients. Fibroblast growth factor-23
(FGF-23) appears to be a risk factor for mortality in patients with end-stage renal disease (ESRD).

Objectives: This study aims to investigate FGF-23 and its association with blood pressure and pulse
pressure among hemodialysis patients.

Patients and Methods: This cross-sectional multicenter study was performed on 135 patients aged 18 years
and over with ESRD treated with hemodialysis. Systolic and diastolic blood pressure of all patients was
measured. FGF-23, uric acid, Na and K were measured using blood test and fasting. We used univariate
and multivariate linear and non-linear regression.

Results: The mean age of patients was 56.45±13.64 years. Around 60% of patients were male. The mean
and median FGF-23 in patients was 855.07±43.33 pg/mL and 762.6 pg/mL (IQR=456.6-1430.3)
respectively. After adjustment for age, gender, dialysis time, uric acid, Na, K and kt/V, FGF-23 had
quadratic association with pulse pressure. We found, each 10-unit (pg/mL) increase in FGF-23 was
significantly associated with 0.50 mm Hg decrease in minimum pulse pressure (P=0.002) and 0.42 mm
Hg decrease in mean pulse pressure (P= 0.009).

Conclusions: FGF23 had a significant association with dialysis vintage and a significant reverse association
with minimum and mean pulse pressure.

In this study we aimed to assess correlation between fibroblast growth factor-23 and pulse pressure and blood pressure in
hemodialysis patients. FGF-23 had a significant reverse association with minimum pulse pressure and mean pulse pressure.